Persistent, unresponsive URI

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violet976

Well-Known Member
Joined
Nov 17, 2009
Messages
1,447
Location
united states
My middle aged boy has been battling a suspected respiratory infection for the past few months. When we got him from the shelter previously, he sounded very piggy like but it cleared up within less than two days - so fast that we wondered if it was even the antibiotics that had worked.

He had then sounded fine for a few months until both him and Minca got very wet sneezes. While Minca has responded to ab's, he has just gotten worse and more piggy-like, though he behaves like normal at this point. So far he's tried 10mg/kg Baytril alone with no response. Then 10mg/kg Baytril + 5mg/kg doxy with no response. Then 10mg/kg Baytril + 30mg/kg Clavamox with no response.

On the advice of others, we attempted upping his Baytril to 20mg/kg while still keeping him on Clavamox, which I thought was the breakthrough. He was completely silent with his breathing, but it only lasted 2 days and he was right back again. I've also been nebulizing him with saline twice a day, cleaning his cage every other day and bed areas daily.

I've got an appointment for Tuesday but I'm looking for any advice on what I should be asking for, or what we should be doing to figure out the root of his issue. Someone suggested zithro, but to be honest many of my rats have had respiratory troubles and zithro has never seemed to help any of them. Someone also suggested trying childrens sudafed in case this is allergy related. I'm happy to try that but I will need to know before I go to my vet, as it's prescription only in Oregon.

I was planning to have him xrayed, as although most agree it sounds nasal at this point, it reminds me of the sounds Nibs had with her pulmonary abscesses. Should I have any other tests done or any specific medications I should be trying at this point?

Here is a video of what his noises sound like. It's older so he wasn't making them as much here, but he still makes the same noises now, just all day/night long...
https://www.flickr.com/photos/scarletnotion/13631220193/
 
When you tried zithro, was it in combination with Baytril? On older rats, zithro alone doesn't do much.
It sounds like it could very much be pulmonary abscesses. In which case, long term meds will keep is at bay until nothing will help.
 
I can't honestly recall if the zithro I tried was alone or with baytril, but my hunch is that in our later treatments we probably combined it. I know for at least one rat it felt like we had run through most ab combinations with no success.

It sounds like pulmonary abscesses are definitely on the table at this point, even though before most thought he sounded "all nasal" which gave me hope. I'll definitely get the xray just to see if it shows anything obvious.

Is sudafed something I should try for at this point? Anything else that might help ease up his congestion? It really sounds to me like something that could be "cleared out", as many times the piggy noises build up until his does a loud sneeze, then they are quiet for a little bit until they build up again, and he sneezes again... you get the picture.
 
dspch911: Just finished reading your thread and found a few things to look into.

Is dex something I should be considering at this point, if he continues to be unresponsive to meds. I'll admit I have been considering it, probably because that was the course of treatment we eventually took for Nibs (who had pulmonary abscesses). I have a ton of it on hand, so I'll certainly bring up that possibility to my vet as well.
 
Stubborn URIs are hard to figure out. The X-ray will give you an idea about whether his heart is enlarged.

I've only used Zithro in combinTion with Baytril.

The other suggestions will also give you a few things to try. Fingers crossed for your ratty.
 
If your vet is willing, I would definitely do dex, sometimes all they need it is a dose of dex once a week, just to give them a boost. Or you could try giving a low dose of metacam daily. With pulmonary abscesses, zithro/baytril combo, keeps my guys alive for several months, with enough quality to their lives.
 
@ Joann: My vet is almost always willing once we get near the stage of nothing else working, or when it has been deemed needed. I also already have a large bottle on hand for emergencies leftover from Nibs and Munster.

I had put off using any because I wanted to make sure the vet saw the exact condition my boy is in - I didn't want the dex to make him appear better than he actually was at the vet. But to be honest, I came very close to giving it to him last night as he was finally getting to that point where he appears to be very bothered by his inability to get air in as he should. He's not at that panicked stage yet, but when he rests now he is still sounding like someone with a very severe stuffed nose, and he's doing more deep side breathing and some longer squeaks where it sounds like he's trying to get a good breath in. He's still eating though, and can still book through the cage for food, so I'm not quite sure if I should wait until a full on attack and try to get him to the vet steroid free for the best assessment on Tuesday.

I had always assumed though, that whatever the vet said, I always had the option to start him on dex on my own if needed as I have it on hand. I just really wanted to approach this one with the vet as he has the expertise and testing available to hopefully see something I can't.
 
@ Jo: For my reference and so I can let me vet know what I would like to try as well (I much prefer having everyone on the same page when possible, and my vet has proven very responsive in these situations), can you tell me what dosage you start out at for the dex? Mine is the Dexaject SP (dexamethasone sodium phosphate), and it states "4mg/mL - equivalent to 3mg/mL dexamethasone).

I've only ever given the stuff at higher dosages, for advanced pulmonary abscesses and once for suspected cancer, so I'm not sure what dosage one starts out with on the lower end.
 
For difficult cases in the past I have used a Zithro/Baytril/Doxy combo. It has worked quite well! This is now my go to when nothing else works.

For respiratory issues, I start my rats at 0.5mg/kg of dex, if that helps I keep them at that, but if it doesn't, I increase to 1mg/kg and gauge from there. The idea with dex is to have them on the lowest dose possible to give a positive result. You don't want to give them more then what is necessary.
 
thanks so much guys. He's still sounding pretty rough but hanging in there so I'm hoping to get him to the vet before I start the dex. I'm very curious to see what his xray shows. I did move the cage into the bathroom tonight and ran a hot shower and it didn't seem to make him any worse, so I'll continue to do that as well.

I'll take all these suggestions to the vet with me. Thanks so much everyone.
 
Back from a doozy of 3 hours at the vet. The vet said Pogo's lungs sounded horrible and he had 2 xrays done. The vet didn't believe his heart looked enlarged, but said it looked like a lot of fluid buildup in the lungs. I asked about pulmonary abscesses but the vet said he did not think it looked like those. He wants to keep Pogo on 15mg/kg Baytril, 30mg/kg clavamox and also attempt adding dex and theophylline to see how he responds. If there is no response he wants to try the heart diagnostic meds.
 
So Pogo no longer has any audible breathing noises at all (he had horrible congestion/grunting but dex/bronchodilator added to his baytril/doxy nixed that issue). Unfortunately, his breathing still seems very rapid to me and he's dropped from 480 grams to 405 in a month or so. His xray a month ago showed a lot of fluid accumulated in his lungs, but the vet didn't think his heart looked enlarged. Should I be opting for lasix as a diagnostic for his heart, or suspecting something else? He's almost weaned off the low dose of dex, and then I was told to wean off the bronchodilator (theophylline), and I'm not sure if the lasix cannot be used side by side with either of those.


Before the horrible congestion he had seemed perfectly fine, no weight loss or other issues that I had seen.
 
Don't know much about the meds, but our Popper (RIP) was on lasix and we were told that decreases appetite. Hope your boy gets better and you find what works for him.
 
If there's actual fluid in the lungs, I'm surprised the vet didn't offer Lasix, even at a lower dose. I'd ask him about this, as it could improve how he breathes and feels. He may not have much appetite anyway if he can't breathe well, but if the fluid can be removed and he feels better, he may still eat. Best of luck with this.
 
The vet went with the bronchodilator, I think because Pogo sounded like he was completely stuffed up at the time. I do know that Pogo's very loud congested breathing stopped within a day or so of treatment, so it was all looking very promising. That was about 10 days ago, and now it's as if we traded loud congested breathing for a large weight loss, rapid breathing and some hunched posture. The weight loss has come on fast which is concerning to me, but he is still eating and active.

If I've dealt with heart issues I've never been aware that I was dealing with them, which is why I'm trying to get other people's opinions as well as my vets. We've just been dealing with so many vet issues it's been hard to get them all squeezed in, and I'm hoping to get Pogo in next week with some more ideas in my mind of what to possibly try.

He doesn't seem to be struggling to breathe now as he did a week and a half ago, but he does seem to be getting tired easily and even at rest he is breathing faster than he normally did. I thought perhaps that might mean a heart issue.
 
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